Optum has introduced Optum Real, an AI-driven system designed to inject real-time clinical and financial insight into every step of the claims and reimbursement process, with the goal of reducing errors, denials and administrative friction.
Glimpse:
Piloted with UnitedHealthcare and Allina Health, Optum Real leverages AI to validate coverage, detect issues at submission, and provide both providers and payers with a more transparent, efficient claims workflow. In early testing, over 5,000 outpatient radiology and cardiology visits have been processed, with a reported drop in administrative errors and improved patient experience.
Optum has rolled out Optum Real, a new AI-powered platform aimed at transforming the traditionally cumbersome claims and reimbursement landscape by bringing increased logic, speed, and transparency. Designed to integrate both clinical and financial capabilities, the system allows providers to determine coverage in real time and ensures payers receive more fully documented claims that reflect each patient’s unique benefits.
The launch, unveiled at HLTH 2025, is currently in pilot mode with UnitedHealthcare (Optum’s affiliated insurer) and Allina Health, a healthcare system encompassing 12 hospitals across Minnesota and Wisconsin. In its initial deployment focused on outpatient radiology and cardiology Optum Real has processed more than 5,000 visits. Allina Health has reported reductions in administrative errors and smoother patient interactions as the platform flags potential issues earlier in the claims process.
Puneet Maheshwari, Senior Vice President and General Manager of Optum Real, emphasized that partner alignment is crucial UnitedHealthcare brings scale, while Allina provides “proof point” credibility in real hospital settings. He noted that bridging payer and provider systems in real time is the recipe for widespread adoption.
As Optum continues deployment, expansion is expected into additional service lines (e.g. surgery) and more payer-provider relationships. If successful, Optum Real could serve as a model for how AI can reduce the friction and uncertainty in healthcare finance and accelerate smoother operational workflows across the sector.
“Imagine healthcare with the ease and clarity of other consumer-like experiences, where patients and providers know their coverage in real time and claim issues are resolved at the point of care.”
By
HB Team
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